DMR Web Design, Web Hosting, Computer Programming & Graphic Arts.

Telephone: 1-215-468-6256
Fax: 1-267-519-9188

Thank you for your interest in DMR Web Design. Please complete this form and click the SUBMIT button to send us your non-obligatory inquiry. One of our representatives will contact you shortly to discuss your needs in detail.

Contact Information

Name of Business:

Your Name:

Title(Owner, Manager, etc.):

Address:

City/State/Zip:

E-Mail:

Telephone:

Best Time to Call:

Project Information

What service are you looking for?

New Web Page Design
Upgrade Existing Web Site
Maintain Existing Web Site
Hosting

Purpose of Web Site (Check all that apply)

Establish a Presence
Provide Information
Provide a Service
Sell Products

Do you have a web site now?Yes No

If "Yes", what is your URL?

Please list a few sites that you like aesthetically in order to give us an idea of what you are looking for. These sites do not have to be in the same field as your business:

URL #1 www.

URL #2 www.

URL #3 www.

Knowing who your competitors are will help us design a site that bests the competition. Can you list the web sites of some of your competitors?

URL #1 www.

URL #2 www.

URL #3 www.

Design Style

I Don't Know
Contemporary
Business Professional
Highly Graphical
Full Flash Site

Number of Static Pages You Would Need:

Do You Have A Logo?

Yes
No, I don't want one
No, but I would like one.

Website Maintenance

I would like to maintain the website myself
I would like to hire a company to maintain it
I want you to maintain it

Additional Functionality (Check all that apply)

Sell Products through a Shopping Cart Program

Do you currently accept credit cards?
No
Yes
No, but I would like to

Member Log-In
Chat Room Capability
Database Search Capability
Other

Hosting

No, I do not require hosting
Yes, I will require hosting

Search Engine Services

No Thank You
Submission to Major Search Engines
Optimization & Submission to Major Search Engines

Detailed Description:

Please give us a detailed description of your company and how you would like to best utilize your web site:

Additional Information

Desired Web Design Budget:

When would you like to start the project?